[JOE]: Small businesses across the country love running payroll with Gusto. Why? Because Gusto automatically files and pays your taxes. It’s super easy to use, plus you can add benefits and management tools to help take care of your counseling team. But here’s the thing, it’s almost 2020 and switching to a new payroll provider can be tricky. Fortunately, Gusto can help as long as you get in touch. Now try a demo and test it out at gusto.com/Joe. You’ll even get three months free when you run your first payroll. That’s gusto.com/Joe. It is the payroll system that I use here at Practice of the Practice.
This is the Practice of the Practice podcast with Joe Sanok, session number 414. Well, welcome back to the series all about starting and growing a group practice. I am here with Alison Pidgeon, consultant with Practice of the Practice and she’s also a group practice owner. And aren’t you like a building owner and a virtual assistant company owner and like how many things do you own?

[ALISON]: I have four LLCs

[JOE]: Oh, my word.

[ALISON]: Yes. So, I own a building. I bought a building last summer and we renovated it, and it opened the beginning of March of 2019. And we gutted it and I got to design it completely how I wanted it.

[JOE]: Which is fun/stressful having done that to a house.

[ALISON]: Yes. It was super stressful going through the process, but now that it’s done, I love it.

[JOE]: I’m with you. Like I feel like I forget how hard it is. We just bought another Airbnb and we’re in the process of making it what we want and it just feels like, “Oh, I just want it to be over,” but then when it’s over, I was like, “Oh, that was so fun to pick all that out,” and I forget all about how hard it was.

[ALISON]: Yes.

[JOE]: Yes. But you did a whole building. That’s a little different than just a little Airbnb.

[ALISON]: Yes. Well it’s a whole another ball game too, because it’s commercial space.

[JOE]: Well, so today we are talking about transitioning from me to us. And by us we don’t mean four LLCs like you, the rock star, but just moving from a solo-preneur to a group practice. Alison, you were telling me before we got recording that almost always one of the questions that people have in your mastermind groups or with your consulting is, “Hey, everyone wants to still see me. Okay, I have this group practice and everyone wants to see me. How do I transition?” So, let’s start there. If someone just started a group practice or maybe they have a group practice but people still want to see the owner, what should they do?

[ALISON]: This question comes up every single time we’re in the mastermind group. Actually, we just launched a new group today and that exact question came up. So, what I tell people is there’s always going to be sort of this growing pain of like you said, people want to see you, the owner, because you’ve been sort of the front person in the business for so long. So, what I learned from you was, had to sort of talk up the other clinician. So, one thing is if you can be the one to stop answering the phone, if you can get an assistant to start answering the phone for you, it’s a lot easier for them to set the boundary than it is for you. I know when I used to answer the phone, I would feel bad and I’d say, “Oh yes, you can come see me.”
Then when I started to have an assistant answer the phone, it got much easier for them just to say, “No, Allison’s not taking new clients right now.” So, we sort of go through a little script of really talking up that clinician like, “Oh, Alison has handpicked Sarah and she’s very similar in her clinical style, and Alison trusts her to see her own clients or,” you know, whatever you want to say. Then just make it really easy for them to schedule like, “Oh, she has openings next week,” or, “She does have evening times and I know that’s what you were asking for.” So, I think there’s always that like transition period and over time as you were, clinicians get more clients, it’s going to be easier and easier to get people to see the other clinicians. Like now nobody calls and asks for me.

[JOE]: Well, and I think that that points to even in episode one of why do a group, that you can charge more because it looks super weird if the owner that’s so exclusive is still charging the same amount as all the other clinicians. You can also pick your times that you want to work. So, it can be, “Yes, if you want to see Alison, she has an opening on Tuesday at 9:00 AM. That’s when she has a sitter and she’s in the office and her cost is X number of dollars per hour or at this cheaper cost and on the time that you want and with the exact specialty you want, you can see this person.” So, it just makes it so much easier to just see your ideal client as the owner, but then also to fill those people up when you set good boundaries around your time.

[ALISON]: Right.

[JOE]: How have you done that in your own practice? Like what do some of those boundaries look like that then make it, that people don’t want to see you as much?

[ALISON]: I think at some point, and this was actually I think back in the fall of 2017 I just said like, I’m not taking any more clients and actually like right before I went on maternity leave, I decided to retire from doing therapy. So that was exciting for me. But, yes, I think you just have to be really clear about, do you want to take new clients or not? And if you don’t, that’s okay. You just have to, again, it’s really easy when the VA’s answering the phone and then I don’t have to deal with all those questions.

[JOE]: Now, would there be a situation when you would see someone or is it that you are retired, like you’re just not going to see anybody no matter that price point or how well they’ll fit in your schedule?

[ALISON]: Yes. No, I’m retired.

[JOE]: All right. look that. That’s a pretty firm boundary.

[ALISON]: Yes. No, it is just, I think for me it’s just been such a great process of like building up the business and working for you as a business consultant and I just love doing that now and I would rather spend my time doing that. Not that I didn’t enjoy being a clinician, but it’s just like time for me to move into the next phase of my career and I feel like this is what I’m meant to be doing now.

[JOE]: I forgot who I heard say it, but they said people overestimate what they can do in a year, but underestimate what they can do in 10 years. I mean, you look at where just four years ago where you were at with things, and growing your practice and where you’re at now. And I look at that pack, you know, five years ago when I was still at the community college. And, it’s crazy what you can get done if you just keep kind of going at it and working hard at it to grow your practice and now be retired.

[ALISON]: Yes, it’s great because it really helped me to get to that point where, you know, we talked about fitting the lifestyle into the business and so I can work less and spend more time with my kids and make more money than I was when I was seeing clients. So that’s great.

[JOE]: How do you handle, because I can see how, because I experienced this when I had my group practice before I sold it, where the clinicians maybe say, “Well, like you’re not here very much. I should get a higher percentage because you’re not working as much,” or that kind of attitude of, like, “Why do you get to just prance into the office whenever you feel like it? We’re doing the real work and you’re just making money off of us.” How have you handled that? And maybe you haven’t had to deal with that but, I’ve heard other people talk about they get clinicians that kind of pushback like that. What’s your approach?

[ALISON]: I think like having somebody else there who’s in charge helps a lot because they, you know, ultimately, they’re making those comments because they want to feel like there’s some kind of safety net there. So, like before I went, actually a long time before I went on maternity leave, like I was grooming somebody to really run the practice for me and then she really fully took over when I was out on leave. And I think that just them knowing she was there and she was basically like me when I wasn’t there, and so, I haven’t knock on wood hard a lot of those comments from therapists I think to like, you know, being quick about, even if I’m not in the office, like I will make a point to like check my email a few times a day and like get back to them pretty quickly. So, then I don’t seem like absent, even though I’m not there. And sometimes now especially because I have the baby with me a lot more, like I’ll just like show up to the office with the baby and just like hang out and I’m not actually working I’m just like there.

[JOE]: Just because you want a break from holding the baby.

[ALISON]: Yes, I want a break from holding the baby but also like, you know, I think it’s good for them just to see like I’m present and I’m not, it’s not like I show up once a month and run a staff meeting and leave. Like even though I’m not necessarily like doing a lot of work while I’m there, like they feel good that if they needed to talk to me or ask me a question that might, I showed up.

[JOE]: Yes. Well, and we’re going to talk a little bit more about managing staff and those systems and, I think in episode four, I’d love to talk a little bit more about kind of non-compete clauses. I’ve seen some people where, they have a clinical director and that clinical director learns everything and then they say, “Oh, I’m going to go do this on my own and I’m going to take all the staff.” So, in episode four, I want to make sure we kind of get into that. But, any other tips around filling up clinicians outside of your own self?

[ALISON]: Yes, I think I’m, one of the big game changers for me was making good relationships with doctors. So, if you think about when you are growing a group practice, you now need a bigger volume of referrals. So, when you were in solo practice, it might’ve been okay that you got a couple of referrals from a couple of therapists here and there and word of mouth or whatever. But now you’re going to have to get many, many more calls and inquiries every week. And so, connecting with a doctor can be great because they may have a case load of thousands of patients and even if they just refer a small percentage of those patients to you, that could be, you know, two, three referrals a week. And then if you have multiple relationships with lots of doctors, then you could be getting 20, 30 calls a week. So, I think you have to think about what is going to be like the best bang for your buck in terms of referrals and getting the volume up, if that makes sense.

[JOE]: Yes, that totally makes sense. Well, we in episode four are going to be talking about managing staff systems and turnover and then in the last episode we’ll be talking about transitioning to a CEO mindset. Alison, thanks so much for being on the podcast today.

[ALISON]: Yes, thank you Joe.

[JOE]: So, if you’re ready to go to the next level and start and grow a group practice, I want you to attend the masterclass that Alison and I are putting on December 10th. This is going to be at 2.30 Eastern, 1.30 Central, 12.30 Mountain, 11.30 Pacific. Head on over to practiceofthepractice.com/grouppracticewebinar. We are going to be talking all about starting and growing your group practice, tips and tricks that you may not have thought of and how you can make money when you’re sick on vacation or on maternity leave. So, again, that’s practiceofthepractice.com/grouppracticewebinar.
So, if you want to get some extra help from Alison and myself, we are doing a webinar on December 10th at 2.30 Eastern, 1.30 Central, 12.30 Mountain, and 1130 Pacific. Head on over to practiceofthepractice.com/grouppracticewebinar and you can get all the information about that webinar, register for it, and get some extra help on starting and growing your group practice.
Also, a special thanks to Gusto who has amazing payroll services. Head on over to gusto.com/Joe to get three months for free. And this podcast is designed to provide accurate and authoritative information in regard to the subject matter covered. It is given with the understanding that neither the host, the publisher or the guests are rendering legal, accounting, clinical, or other professional information. If you want a professional, you should find one.